DERMATITIS OR ECZEMA

A. ISHIZAWAR · 2026 · Case ID: A26032527

MIXED

Summary

The Veteran served from October 1990 to October 1994. The Veteran appealed denials of service connection for chronic rhinitis, a sinus disorder, and right and left hip disorders, claiming toxic exposure through his MOS and secondary aggravation of hip conditions by service-connected knee disabilities. The Board found that the Veteran's claims for chronic rhinitis, sinus disorder, and right and left hip disorders were not established because the post-service treatment records and February 2024 VA examinations did not support a current diagnosis or objective findings of functional impairment. The Board noted that while the Veteran reported symptoms, the objective examinations were within normal limits and the medical evidence was more probative than the lay evidence. The Board denied service connection for these conditions. However, the Board remanded claims for service connection for a headache disorder and status post spinal fusion. The remand for the headache disorder was due to an inadequate VA examination that failed to provide a diagnosis or address the Veteran's reported symptoms and submitted log. The remand for the spinal fusion claim was due to an inadequate opinion on secondary aggravation from the service-connected knee disabilities, as separate opinions for causation and aggravation were required but not provided.

Rationale

No current diagnosis of chronic rhinitis; No objective findings on examination; Post-service treatment records are silent

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250221-522834

Full Decision Text

Citation Nr: A26032527
Decision Date: 04/08/26 Archive Date: 04/08/26

DOCKET NO. 250221-522834
DATE: April 8, 2026

ORDER

Service connection for chronic rhinitis, allergic or non-allergic, is denied.

Service connection for sinus condition is denied.

Service connection for a right hip disorder is denied.

Service connection for a left hip disorder is denied.

REMANDED

Entitlement to service connection for a headache disorder is remanded.

Entitlement to service connection for status post spinal fusion is remanded.

FINDINGS OF FACT

1. The evidence of record persuasively weighs against finding that the Veteran has had chronic rhinitis, allergic or non-allergic, at any time during or approximate to the pendency of the claim.

2. The evidence of record persuasively weighs against finding that the Veteran has had a sinus disorder at any time during or approximate to the pendency of the claim.

3. The evidence of record persuasively weighs against finding that the Veteran has had a right hip disorder at any time during or approximate to the pendency of the claim.

4. The evidence of record persuasively weighs against finding that the Veteran has had a left hip disorder at any time during or approximate to the pendency of the claim.

CONCLUSIONS OF LAW

1. The criteria for service connection for chronic rhinitis, allergic or non-allergic, have not been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

2. The criteria for service connection for a sinus disorder have not been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

3. The criteria for service connection for a right hip disorder have not been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

4. The criteria for service connection for a left hip disorder have not been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from October 1990 to October 1994.

These matters come before the Board of Veterans' Appeals (Board) on appeal from various rating decisions issued by a Department of Veterans Affairs (VA) Regional Office (RO), under the modernized review system, also known as the Appeals Modernization Act (AMA).

A June 2024 rating decision denied, in pertinent part, service connection for a headache disorder, chronic rhinitis disorder, sinus disorder, lower back disorder, and right and left hip disorders. In July 2024, the Veteran filed a VA Form 20-0996, Decision Request Review: Higher-Level Review (HLR) to seek review of the June 2024 rating decision. A HLR Informal Conference was held in October 2024, and in a October 2024 HLR decision, the agency of original jurisdiction (AOJ) considered the evidence of record at the time of the June 2024 rating decision and continued the denials of service connection for a headache disorder, chronic rhinitis disorder, sinus disorder, and right and left hip disorders.

The October 2024 HLR decision also found a duty-to-assist error with regard to the lower back disorder, now characterized as status post spinal fusion, and that issue was moved to the Supplemental Claim lane for further development. The supplemental claim decision was issued in February 2025.

In the February 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket and identified the June 2024 and February 2025 rating decisions. Although the Notice of Disagreement was received within one year of the June 2024 rating decision, as outlined above, the Veteran previously requested review of that decision, and the AOJ readjudicated the claims for service connection for a headache disorder, chronic rhinitis disorder, sinus disorder, and right and left hip disorders on their merits in the October 2024 HLR decision. For this reason, the Board liberally construes the February 2025 Notice of Disagreement as appealing the
In the February 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket and identified the June 2024 and February 2025 rating decisions. Although the Notice of Disagreement was received within one year of the June 2024 rating decision, as outlined above, the Veteran previously requested review of that decision, and the AOJ readjudicated the claims for service connection for a headache disorder, chronic rhinitis disorder, sinus disorder, and right and left hip disorders on their merits in the October 2024 HLR decision. For this reason, the Board liberally construes the February 2025 Notice of Disagreement as appealing the October 2024 rating decision for these issues. See 38 C.F.R. § 3.2500(c). Notably, the Veteran is not prejudiced by this interpretation as the Board will be reviewing the same body of evidence, given that for these issues, the Board may only consider the evidence of record at the time of the June 2024 rating decision, which was subsequently subject to higher-level review. Additionally, the Board's interpretation of the Notice of Disagreement as appealing the October 2024 HLR decision in this case does not preclude the Board from adjudicating the claims on their merits. Cf. Terry v. McDonough, 37 Vet. App. 1 (2023).

Due to the Veteran's election of the Direct Review docket, the Board may only consider the evidence of record at the time of the June 2024 AOJ decision, which was subsequently subject to higher-level review, with regard to the headache, chronic rhinitis, sinus, and right and left hip disorder appeals, and the February 2025 decision with regard to the status post spinal fusion disorder appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decisions on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801.

For the chronic rhinitis disorder, sinus disorder, right hip disorder, and left hip disorder claims, if the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, he may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

However, because the Board is remanding the claims of service connection for a headache disorder and status post spinal fusion disorder, any evidence the Board could not consider will be considered by the AOJ in the adjudication of those claims. 38 C.F.R. § 3.103(c)(2)(ii).

Service Connection

Service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated by service.?See 38?C.F.R. §§?3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009).?

Service connection may be granted on a presumptive basis for diseases listed in 38?C.F.R. § 3.309?under the following circumstances: (1) where a chronic disease or injury is shown in service and subsequent manifestations of the same disease or injury are shown at a later date unless clearly attributable to an intercurrent cause; or (2) where there is continuity of symptomatology since service; or (3) by showing that the disorder manifested itself to a degree of 10 percent or more within one year from the date of separation from service. See 38 C.F.R. § 3.307.

Establishing service connection on a secondary basis requires evidence sufficient to show that (1) a current disability exists and (2) the current disability was either (a) caused by or (b) aggravated by a service-connected disability.?38 C.F.R. §?3.310. Secondary causation exists when, but for the service-connected disability, the non-service-connected disability was caused by a service-connected disability either in a direct, etiological way or via multiple steps in a causal chain. Spicer?v. McDonough,?61 F.4th 1360, 1365?(Fed. Cir. 2023) (citations omitted). Secondary aggravation exists when the non-service-connected disability not caused by a service-connected disability would be less severe were it not for a service-connected disability. Id. at 1364.?For example, secondary aggravation may be established where the natural progression of the non-service-connected disability could have been arrested or improved but for the service-connected disability. Id.

Entitlement to service connection for chronic rhinitis, allergic or non-allergic.

Entitlement to service connection for a sinus disorder is denied.

Entitlement to service connection for a right hip disorder is denied.

Entitlement to service connection for left hip disorder is denied.

The Veteran seeks service connection for chronic rhinitis and a sinus disorder claiming that he was exposed to toxic elements through his military occupational specialty (MOS). He also claims that service connection for a bilateral hip disorder is warranted as secondary to his service-connected right and left knee disabilities. See February 2024 VA Form 21-526EZ; October 2024 HLR Informal Conference.

Initially, both the June 2024 and October 2024 AOJ decisions rendered favorable findings regarding in-service incurrence. Specifically, the AOJ identified in-service toxic exposure risk activities (TERA) for all claims. See also February 2024 VA TERA Memorandum (noting the Veteran's exposure to TERA as a bulk petroleum supply specialist). In addition, a primary service-connected disability of the left knee was reported for the Veteran's secondary service connection claims for the right and left hip disorders. The October 2024 AOJ decision also identified the Veteran's status post spinal fusion diagnosis as a primary disability for the right and left hip claims.

However, the post-service treatment evidence does not establish a currently diagnosed chronic rhinitis disorder, sinus disorder, or disorder of the right or left hip disorder. The Veteran was afforded VA examinations for each of these disorders in February 2024. In each case, while the Veteran reported symptoms, the examiner found that the Veteran's subjective complaints and clinical findings did not support a diagnosis for each of the claimed disorders.

Particularly, regarding the right and left hip disorders, the Veteran described experiencing aching in the hips on a daily basis, but the clinical examination revealed no limitation of range of motion for either hip or other signs of functional impairment. The VA examiner stated that there were no findings, signs and/ or symptoms to support a diagnosis. The examiner also indicated that there was insufficient evidence in the medical record or on the examination to support the claim of a chronic right and/or left hip disorder. The examiner noted that symptoms were only subjectively reported and the objective examination was within normal limits.

For the chronic rhinitis and sinusitis disorders, the Veteran reported that he experienced symptoms of runny nose, watery eyes, and glossy eyes. He also reported that he managed his conditions with nasal lavages and over the counter Zyrtec as needed. On examination, however, no objective findings attributable to either sinusitis or rhinitis were indicated. An X-ray of the paranasal sinuses performed at the time was normal. The VA examiner found that there were no findings, signs and/or symptoms to support a diagnosis in either the medical record or on the examination to support a diagnosis of rhinitis or sinusitis. The examiner stated that the symptoms were only subjective and the objective examination was within normal limits.

A review of the available treatment records does not reveal any complaints, treatment, or diagnosis associated with chronic rhinitis, sinus, or left and right hip disorders. Therefore, the first element of service connection is not established for these appeals.

Regarding the Veteran's general claim for service connection, he is competent to attest to his symptoms. However, he is not competent as a lay person to provide a diagnosis. Diagnosing chronic rhinitis, a sinus disorder, or disorder of either hip requires specialized medical education and the ability to interpret complicated diagnostic medical testing. See Jandreau v. Nicholson, 492 F.3d 1372 (2007). Moreover, the Veteran has not offered any specific contentions or arguments as to his current symptoms and
available treatment records does not reveal any complaints, treatment, or diagnosis associated with chronic rhinitis, sinus, or left and right hip disorders. Therefore, the first element of service connection is not established for these appeals.

Regarding the Veteran's general claim for service connection, he is competent to attest to his symptoms. However, he is not competent as a lay person to provide a diagnosis. Diagnosing chronic rhinitis, a sinus disorder, or disorder of either hip requires specialized medical education and the ability to interpret complicated diagnostic medical testing. See Jandreau v. Nicholson, 492 F.3d 1372 (2007). Moreover, the Veteran has not offered any specific contentions or arguments as to his current symptoms and diagnosis. Therefore, the Board finds the medical evidence of record to be more probative than the lay evidence. As indicated above, the Veteran's post-service treatment records are silent for any current diagnoses, to include any symptoms that cause functional impairment of earning capacity.

Based on the foregoing, the Board finds that there is no evidence to show that the Veteran has been diagnosed with or treated for a current disorder of chronic rhinitis, a sinus disorder, a right hip disorder, or a left hip disorder at any time during the pendency of the claim or contemporaneous to the filing of the claims. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). Indeed, the Veteran has not presented any evidence to demonstrate that he has had symptoms of any of these disorders that have reached the level of functional impairment of earning capacity sufficient to be reasonably interpreted as a current disability under the governing statutes and regulations. See Saunders v. Wilkie, 886 F. 3d 1356, 1365-68 (2018).

In the absence of competent evidence of a current disability, there is no basis upon which service connection may be granted. See Brammer v. Derwinski, 3?Vet. App.?223, 225 (1992). Accordingly, the claims for service connection for chronic allergic or non-allergic rhinitis, a sinus disorder, a right hip disorder, and a left hip disorder must be denied.

REASONS FOR REMAND

Under the AMA, the Board is responsible for identifying duty to assist errors made by the AOJ prior to the decision on appeal. Remand must be for duty to assist errors that are "pre-decisional." 38?C.F.R. §?20.802(a). When the Board identifies a duty to assist error made by the AOJ, the Board will remand the appeal with instructions to correct the error.?38?C.F.R. §§?3.159(c), 20.802(a). In this case, the Board determines that the AOJ did not fulfill its duty-to-assist by getting adequate nexus opinions for the headache disorder and back disorder claims.

Entitlement to service connection for a headache disorder is remanded.

The Veteran was afforded a VA examination in February 2024 to assess the nature and etiology of his headaches. The examiner did not render a diagnosis of a headache disorder, indicating that there were no findings, signs and/or symptoms to support a diagnosis. The examiner stated that symptoms were subjective only, and the objective examination was within normal limits.

However, the Veteran described currently experiencing three to five migraine headaches a month, that lasted from one to two hours and that were manifested by pulsating pain, located in the temples. On the Headache Disability Benefits Questionnaire (DBQ), the VA examiner noted that the Veteran experienced pulsating or throbbing head pain on both sides of the head along with nausea. The examiner also documented characteristic prostrating attacks of headache pain less than once in two months. By virtue of the nature of a headache disability, the symptoms documented are based on the Veteran's self-report of his experiences. Objective findings requested in the Headache DBQ pertain to Section VI: Diagnostic Testing, Section VII: Functional Impact, and possibly to Section V: Other Pertinent Physical Findings & Complications, Conditions, Signs, Symptoms, and Scars. The examiner stated that objective findings were within normal limits, but no objective findings, normal or otherwise, were reported in the DBQ. The examiner also did not address why the Veteran's reported symptoms were not indicative of a diagnosable headache disorder or discuss the Headache/Migraine Log the Veteran submitted in February 2024, before the examination.

For these reasons, the Board finds the February 2021 VA headache examination and associated opinion to be inadequate. Not obtaining an adequate examination and opinion was a pre-decisional error requiring remand.

Entitlement to service connection for status post spinal fusion is remanded.

VA
V: Other Pertinent Physical Findings & Complications, Conditions, Signs, Symptoms, and Scars. The examiner stated that objective findings were within normal limits, but no objective findings, normal or otherwise, were reported in the DBQ. The examiner also did not address why the Veteran's reported symptoms were not indicative of a diagnosable headache disorder or discuss the Headache/Migraine Log the Veteran submitted in February 2024, before the examination.

Entitlement to service connection for status post spinal fusion is remanded.

VA examinations and opinions were obtained in February 2024 and October 2024 for the back disorder claim. The February 2024 VA examiner found that the diagnosed status post spinal fusion was not due to or a result of the service-connected left knee disability because the two disorders were separate and unrelated. Thus, a causal relationship was not demonstrated, and a nexus was not established.

The October 2024 VA examiner found that there was no objective evidence to show that Veteran's status post spinal fusion was caused by the Veteran's service- connected bilateral knee strain disability. The examiner did not provide a separate opinion on the matter of whether there was aggravation of the back disability by the bilateral knee disability. Separate opinions must be provided for causation and aggravation in claims for service connection on a secondary basis. Therefore, the AOJ did not obtain all necessary opinions prior to the decision on appeal. Not doing so was a pre-decisional error requiring remand.

The matters are REMANDED for the following actions:

1. Obtain an addendum opinion as to the nature and etiology of the Veteran's headache disorder. The clinician must review the record, including a copy of this remand, and then respond to the following:

" Is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran has a headache disorder that is causally or etiologically related to toxic exposures associated with his MOS of Bulk Petroleum Supply Specialist as noted in the February 2024 TERA memorandum?

The examiner is directed to specifically consider and address:

o the total potential exposure through all applicable deployments; and

o the synergistic, combined effect of all toxic exposure risk activities of the Veteran.

" Is it at least as likely as not (that is, a likelihood is at least approximately balanced or nearly equal) that any headache disorder diagnosed was i) caused OR ii) aggravated by his service-connected tinnitus?

The clinician is asked to provide two separate opinions, one for i) causation and another for ii) aggravation.

Causation means that the disorder is caused by or the result of.

Aggravation means a worsening in the condition, but the worsening does not have to be permanent.

If separate opinions are not provided for causation and aggravation, the opinion will be returned as inadequate.

The examiner is advised that the Veteran is competent to report his symptoms/history and that such reports must be acknowledged and considered in formulating any opinion. If his reports are discounted, the examiner should provide a reason for doing so.

If the examiner determines that a physical examination of the Veteran is needed in order to provide the requested medical opinion, such should be arranged.

A rationale for all requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question.

2. Direct the claims file to a clinician in order to obtain a medical opinion as to the etiology of the Veteran's status post spinal fusion disability. After a review of the file, the clinician is asked to address the following:

" Is it at least as likely as not (that is, a likelihood is at least approximately balanced or nearly equal) that the Veteran's back disorder, diagnosed as status post spinal fusion, is i) caused OR ii) aggravated by the service-connected right knee strain and/or left knee degenerative arthritis, to include any change in body mechanics resulting from the Veteran's knee disabilities?

The clinician is asked to provide two separate opinions, one for i) causation and another for ii) aggravation.

Causation means that the disorder is caused by or the result of.

Aggravation means a worsening in the condition, but the worsening does not have to be permanent.

If separate opinions are not provided for causation and aggravation, the opinion will be returned as inadequate.

The examiner is advised that
, a likelihood is at least approximately balanced or nearly equal) that the Veteran's back disorder, diagnosed as status post spinal fusion, is i) caused OR ii) aggravated by the service-connected right knee strain and/or left knee degenerative arthritis, to include any change in body mechanics resulting from the Veteran's knee disabilities?

The clinician is asked to provide two separate opinions, one for i) causation and another for ii) aggravation.

Causation means that the disorder is caused by or the result of.

Aggravation means a worsening in the condition, but the worsening does not have to be permanent.

If separate opinions are not provided for causation and aggravation, the opinion will be returned as inadequate.

If the examiner determines that a physical examination of the Veteran is needed in order to provide the requested medical opinion, such should be arranged.

A. ISHIZAWAR

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board K. M. Schaefer

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.

Analyze in VA Law Explorer